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Search Results: 1 - 10 of 192442 matches for " Michel Pompeu Barros de Oliveira; "
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Automedica??o em idosos na cidade de Salgueiro-PE
, Mirivaldo Barros e;Barros, José Augusto Cabral de;Sá, Michel Pompeu Barros de Oliveira;
Revista Brasileira de Epidemiologia , 2007, DOI: 10.1590/S1415-790X2007000100009
Abstract: objectives: to identify the determinants associated with the practice of self-medication in the 60-year-old or older population in the city of salgueiro/pernambuco/brazil. methods: a cross-sectional study was carried out in the urban zone in the city of salgueiro - pe; questionnaires were handed out between may/01/2004 and june/06/2004 in a sample population of 355 persons aged 60 years or more. data were processed and analyzed using epiinfo 6.04 software after a double entry and validated. results: the sample was comprised of 44.9% (159/355) 60-70-year olds, 69.8% (247/355) of which were female, 53.1% (188/355) illiterate, 40.7% (145/355) without having finished high school, and 77.7% (276/355) retired. in the group that used medicines without medical prescription, the drugs used most often were analgesics (30%) and antipyretics (29%). of the reasons presented to justify the use of self-prescribed medicines, pain was the most frequent one (38.3%), followed by fever (24.4%), diarrhea (8.0%), hypertension (8.0%) and cough (5.2%). there was association between the lack of exercise and self-medication (x2 =14.44 p=0.001). conclusions: there is a high prevalence of self-medication in this group; analgesics and antipyretics are the drugs used most often; pain is the symptom that most leads to self-medication; and sedentary individuals use more self-medication than those who exercise.
Educa??o Permanente em SBV e SAVC: impacto no conhecimento dos profissionais de enfermagem
Lima, Sandro Gon?alves de;Macedo, Larissa Araripe de;Vidal, Marcela de Lima;Sá, Michel Pompeu Barros de Oliveira;
Arquivos Brasileiros de Cardiologia , 2009, DOI: 10.1590/S0066-782X2009001200012
Abstract: background: the theoretical knowledge and practical skills of the basic life support (bls) and the advanced life support (als) are among the most important determining factors of the cardiopulmonary reanimation success rates. objective: assess the impact of a permanent training program in bls and als on the knowledge of nursing professionals. method: cross-sectional study. population was made of nursing professionals of a tertiary level hospital. assessments were carried out before and after training. the critical points of the international liaison committee on resuscitation (ilcor) analysis were addressed. results: 213 professionals were assessed (76 nurses, 35.7%; 38 assistants, 17.8%; and 99 technicians, 46.7%). pre-course assessment average grades were statistically different (p<0.001) among assistants (3.25), technicians (3.96) and nurses (4.69). single professional without kids showed performance significantly superior to married professional with kids (p=0.02 and 0.004 respectively). pre-training level of knowledge was inversely proportional to the time elapsed since the completion of undergraduate course or technical course. main deficiencies were related to the initial approach of airways, to post-resuscitation cares and to the external cardiac massage technique. the post-course general average grade was 7.26. assistants achieved a performance of 131.2%, technicians, of 78.9% and the nurses, of 85%, with no significant statistic difference (p=0.43). conclusion: the permanent training program in bls and als resulted in important increment in the level of knowledge of nursing professionals.
GuaragnaSCORE satisfactorily predicts outcomes in heart valve surgery in a Brazilian hospital
, Michel Pompeu Barros de Oliveira;Sá, Marcus Villander Barros de Oliveira;Albuquerque, Ana Carla Lopes de;Silva, Belisa Barreto Gomes da;Siqueira, José Williams Muniz de;Brito, Phabllo Rodrigo Santos de;Vasconcelos, Frederico Pires;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2012, DOI: 10.5935/1678-9741.20120003
Abstract: objective: the aim of this study is to evaluate the applicability of guaragnascore for predicting mortality in patients undergoing heart valve surgery in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape, recife, pe, brazil. methods: retrospective study involving 491 consecutive patients operated between may/2007 and december/2010. the registers contained all the information used to calculate the score. the outcome of interest was death. association of model factors with death (univariate analysis and multivariate logistic regression analysis), association of risk score classes with death and accuracy of the model by the area under the roc (receiver operating characteristic) curve were calculated. results: the incidence of death was 15.1%. the nine variables of the score were predictive of perioperative death in both univariate and multivariate analysis. we observed that the higher the risk class of the patient (low, medium, high, very high, extremely high), the greater is the incidence of postoperative af (0%; 7.2%; 25.5%; 38.5%; 52.4%), showing that the model seems to be a good predictor of risk of postoperative death, in a statistically significant association (p <0.001). the score presented a good accuracy, since the discrimination power of the model in this study according to the roc curve was 78.1%. conclusions: the brazilian score proved to be a simple and objective index, revealing a satisfactory predictor of perioperative mortality in patients undergoing heart valve surgery at our institution.
Perfil clínico-cirúrgico de pacientes operados por ruptura do septo interventricular pós-infarto do miocárdio
, Michel Pompeu Barros de Oliveira;Sá, Marcus Villander Barros de Oliveira;Barbosa, Caio Henrique;Silva, Niedjon Peixoto de Carvalho;Escobar, Rodrigo Renda de;Rueda, Fábio Gon?alves de;Silva, Frederico Pires Vasconcelos;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000300010
Abstract: objectives: to study clinical features, complications and in-hospital outcomes of patients operated for postinfarction ventricular septal rupture. methods: a retrospective study involving 21 patients between january/1996 and june/2009. all operations were performed at the division of cardiovascular surgery of complexo hospitalar huoc/procape. results: mean age of patients was 62.81 years (± 8.21), 61.9% (n = 13) were male. rupture occurred on average 4.8 days after infarction. cardiogenic shock was observed in 57.1% (n = 12), being risk factor for death (100% with shock vs. 22.2% without shock; p<0.001). survivors had a higher mean ejection fraction compared to deaths (66.29% ± 4.61% versus 42.71% ± 4.79%, p <0.001). all were classified as high risk by the euroscore, and the survivors had lower average score compared to deaths (6.57 ± 0.53 versus 10.93 ± 2.23; p <0.001). the majority (76.2%, n = 16) of the patients needed to use vasoactive drugs and 57.1% (n = 12) considered hemodynamically unstable. need for vasoactive drugs was a risk factor for death (81.3% with vasoactive drugs versus 20% without vasoactive drugs, p = 0.025). hemodynamic instability was also a risk factor for death (100% in the unstable group versus 22.2% in the stable group; p <0.001). the rate of in-hospital mortality was 66.7% (n = 14). conclusions: the need for vasoactive drugs, hemodynamic instability and cardiogenic shock were associated with higher rates of mortality. patients who had adverse outcomes had less ventricular function and higher score in the euroscore. mortality remains high
Predicting risk of atrial fibrillation after heart valve surgery: evaluation of a Brazilian risk score
, Michel Pompeu Barros de Oliveira;Sá, Marcus Villander Barros de Oliveira;Albuquerque, Ana Carla Lopes de;Silva, Belisa Barreto Gomes da;Siqueira, José Williams Muniz de;Brito, Phabllo Rodrigo Santos de;Ferraz, Paulo Ernando;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2012, DOI: 10.5935/1678-9741.20120017
Abstract: objective: the aim of this study is to evaluate the applicability of a brazilian score for predicting atrial fibrillation (af) in patients undergoing heart valve surgery in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape (recife, pe, brazil). methods: retrospective study involving 491 consecutive patients operated between may/2007 and december/2010. the registers contained all the information used to calculate the score. the outcome of interest was af. we calculated association of model factors with af (univariate analysis and multivariate logistic regression analysis), and association of risk score classes with af. results: the incidence of af was 31.2%. in multivariate analysis, the four variables of the score were predictors of postoperative af: age >70 years (or 6.82; 95%ci 3.34-14.10; p<0.001), mitral valve disease (or 3.18; 95%ci 1.83-5.20; p<0.001), no use of beta-blocker or discontinuation of its use in the postoperative period (or 1.63; 95%ci 1.05-2.51; p=0.028), total fluid balance > 1500 ml at first 24 hours (or 1.92; 95%ci 1.28-2.88; p=0.002). we observed that the higher the risk class of the patient (low, medium, high, very high), the greater is the incidence of postoperative af (4.2%; 18.1%; 30.8%; 49.2%), showing that the model seems to be a good predictor of risk of postoperative af, in a statistically significant association (p<0.001). conclusions: the brazilian score proved to be a simple and objective index, revealing a satisfactory predictor of development of postoperative af in patients undergoing heart valve surgery at our institution.
Skeletonized internal thoracic artery is associated with lower rates of mediastinitis in elderly undergoing coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Ferraz, Paulo Ernando;Soares, Alexandre Magno Macário Nunes;Bezerra, Pablo César Lustosa Barros;Martins, Wendell Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110053
Abstract: background and objectives: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. the aim of this study is to identify which option of harvesting internal thoracic artery (ita), pedicled or skeletonized, is associated with lower rates of mediastinitis after coronary artery bypass grafting surgery (cabg) in elderly, in the division of cardiovascular surgery of procape. methods: retrospective study of 160 elderly who underwent consecutive cabg between may 2007 and june 2011. eleven preoperative variables, four intraoperative variables and eight postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated between two groups: cabg with skeletonized ita (n=80) and pedicled ita (n=80). univariate and multivariate logistic regression analyses were applied. results: the incidence of mediastinitis was 6.8% (n=11), with a lethality rate of 54.5% (n=6). the skeletonized ita group were more exposed than pedicled ita group to obesity (n=12 vs. n=4; 15% vs. 5%; p=0.035) and multiple transfusions (n=25 vs. n=11; 31.2% vs. 13.7%; p=0.008). the pedicled ita group presented a greater risk of mediastinitis after cabg than skeletonized ita group (n=10 vs. n=1; 12.5% vs. 1.2%; unadjusted or 11.3; 95% ci 1.4 - 241.5; p=0.008). in multivariate analysis, this difference maintained statistically significant (adjusted or 5.2; 95% ci 1.5-495.8; p=0.012), being considered an independent association. conclusions: we suggest that elderly should be considered for strategies to minimize risk of infection. in elderly that undergo unilateral ita, the problem seems to be related to how ita is harvested. elderly should always be considered for use of skeletonized ita.
ética em pesquisas com seres humanos: do conhecimento à prática
Lima, Sandro Gon?alves de;Lima, Tatiana Albuquerque Gon?alves de;Macedo, Larissa Araripe de;Sá, Michel Pompeu Barros de Oliveira;Vidal, Marcela de Lima;Gomes, Rafael Alessandro Ferreira;Oliveira, Laura Correia;Santos, Ana Maria Aguiar;
Arquivos Brasileiros de Cardiologia , 2010, DOI: 10.1590/S0066-782X2010005000097
Abstract: background: in brazil, resolution 196/96 and its amendments regulate the preservation of rights, respect and dignity of human beings involved in research. objective: to analyze the adequacy of free communications (fc) presented during the xviii congresso pernambucano de cardiologia to resolution 196/96. methods: during a cross-sectional study, interviews were carried out with the authors of the fc presented at the congress and the abstracts of the studies were assessed in order to identify the need for previous approval by a research ethics committee (rec). results: a total of 90 fc were presented and, in most of them (86.8%), medical files were the most commonly used source of data. only 23.1% of the fc were submitted to the assessment of a rec and 15.4% of them used a free and informed consent form (ficf). among the authors whose studies were not assessed by a rec, 65.6% stated that this conduct was not necessary and 18% of them were unaware of the need to submit the study to such assessment. the written authorization given by the institution where the fc were carried out was not obtained in 56.6% of the studies. most of the authors (80.0%) stated that they had never read resolution 196/96. the proportion of fc submitted to a rec was significantly higher among authors that had read resolution 196/96 (p = 0.005). the fc design influenced the non-submission of the studies to a rec (p < 0.001). most of the fc that were authorized by the institution where they were carried out were submitted to a rec (p < 0.001). conclusion: most of the fc presented at the congress did not follow the brazilian regulations concerning the ethics in research.
Mediastinite no pós-operatório de cirurgia cardiovascular: análise de 1038 cirurgias consecutivas
, Michel Pompeu Barros de Oliveira;Silva, Débora Oliveira;Lima, érika Nibbering de Souza;Lima, Ricardo de Carvalho;Silva, Frederico Pires Vasconcelos;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Cavalcanti, Paulo Ernando Ferraz;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000100008
Abstract: objective: to report the incidence of mediastinitis in cardiovascular surgery postoperation. methods: the records of all 1038 patients who underwent cardiovascular surgical procedures between may/2007 and june/2009 were reviewed. all operations were performed in division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. results: the complication occurred within, on average, 13 days after operation, in total of 25 (2.4%), eight (32%) deaths occurred. several risk factors mediastinitis were identified: 56% diabetes, 56% smokers, 20% obeses, 16% with chronic obstructive pulmonary disease and 8% of chronic renal failure. mediastinitis were reported in 21 (84%) cases of patients submitted to coronary artery bypass grafting, being associated to major risk of infection development (ic 3.448.30, p=0.0001). high rates of complications were observed: respiratory insufficiency (44%), stroke (16%), cardiogenic shock (12%), acute renal failure (28%), pulmonary infection (36%), multiple organs failure (16%) and esternal deiscence (48%). bacterial cultures of exudates were positive in 84% of patients; staphylococcus aureus was the most responsible pathogen (28.8%). conclusion: mediastinitis stays a serious surgical complication and difficult management in cardiovascular surgery postoperation. the disease stays with low incidence, but still with high lethality. coronary bypass was associated to major risk of infection development.
Validation of MagedanzSCORE as a predictor of mediastinitis after coronary artery bypass graft surgery
, Michel Pompeu Barros de Oliveira;Figueira, Evelyn Soares;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110013
Abstract: objective: the aim of this study is to evaluate the applicability of a new score for predicting mediastinitis - magedanzscore - in patients undergoing coronary artery bypass graft (cabg) surgery in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: retrospective study involving 500 patients operated between may/2007 and april/2010. the registers contained all the information used to calculate the magedanzscore. the outcome of interest was mediastinitis. we calculated sensitivity, specificity, positive predictive value, negative predictive value, concordance and accuracy. the accuracy of the model was evaluated by roc (receiver operating characteristic) curve. results: the incidence of mediastinitis was 5.6%, with a lethality rate of 32.1%. in univariate analysis, the five variables of the magedanzscore were predictors of postoperative mediastinitis: chronic obstructive pulmonary disease (or 6.42; 95.0% ci 2.76-14.96; p<0.001), obesity (or 3.06; 95.0% ci 1.32-7.09; p=0.009), surgical reintervention (or 82.40; 95.0% ci 30.40-223.30; p<0.001), multiple transfusion (or 3.33; 95.0% ci 1.52-7.29; p=0.003) and stable angina class iv or unstable (or 2.59; 95.0% ci 1.19-7.64; p=0.016) according to canadian cardiovascular society. the score had a sensitivity of 96.4%, specificity of 90.0%, positive predictive value of 36.5%, negative predictive value of 99.8% and 90.4% concordance. the accuracy measured by the area under the roc curve was 96.2% (95.0% ci 94.5%-97.9%). conclusions: the magedanzscore proved to be a simple and objective index, revealing a satisfactory predictor of development of postoperative mediastinitis in patients undergoing cabg surgery at our institution
Predictors of transfusion of packed red blood cells in coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110044
Abstract: objectives: finding predictors of blood transfusion may facilitate the most efficient approach for the use of blood bank services in coronary artery bypass grafting procedures. the aim of this retrospective study is to identify preoperative and intraoperative patient characteristics predicting the need for blood transfusion during or after cabg in our local cardiac surgical service. methods: 435 patients undergoing isolated first-time cabg were reviewed for their preoperative and intraoperative variables and analyzed postoperative data. patients were 255 males and 180 females, with mean age 62.01 ± 10.13 years. regression logistic analysis was used for identifying the strongest perioperative predictors of blood transfusion. results: blood transfusion was used in 263 patients (60.5%). the mean number of transfused blood products units per patient was 2.27 ± 3.07 (0-23) units. the total number of transfused units of blood products was 983. univariate analysis identified age >65 years, weight <70 kg, body mass index <25 kg/m2, hemoglobin <13mg/dl, hematocrit < 40% and ejection fraction <50%, use of cardiopulmonary bypass (cpb), not using an internal thoracic artery as a bypass, and multiple bypasses as significant predictors. the strongest predictors using multivariate analysis were hematocrit < 40% (or 2.58; ci 1.62-4.15; p<0.001), cpb use (or 2.00; ci 1.27-3.17; p=0.003) and multiple bypasses (or 2.31; ci 1.31-4.08; p=0.036). conclusions: the identification of these risk factors leads to better identification of patients with a grater probability of using blood, allocation blood bank resources and cost-effectiveness use of blood products.
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